Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0007138 (transitional cell carcinoma)
 3,949 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 46-year-old Japanese man was diagnosed with a left renal pelvic carcinoma and a contralateral hypoplastic kidney. The tumor was adjacent to the renal pelvis and was considered too difficult to completely resect in situ. The patient was treated by ex vivo partial nephrectomy of the left kidney followed by autotransplantation of the remaining renal segment. A pathologic evaluation revealed a transitional cell carcinoma, G2, pT3. Graft function recovered satisfactorily postautotransplantation and no significant complications developed during the postoperative period. The patient is alive and doing well 12 months postoperatively with no evidence of tumor recurrence.
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PMID:Ex vivo partial nephrectomy and partial kidney autotransplantation for renal pelvic carcinoma in a functionally solitary kidney: case report. 925 37

Mutations of p53 gene have been found in a variety of human malignancies; however, the impact of immunohistological detection of p53 expression in the development and progression of TCC of the bladder is still uncertain. In the present study, we investigated the p53 oncoprotein expression and compared the findings to DNA ploidy and pathohistological stage and grade. The study included 147 patients with transitional cell carcinoma of the bladder investigated between February 1981 and September 1994. The average age of the 55 women and 92 men was 67 years (range: 20-71 years). A total of 76 patients (52%) had stage pTa to pT1, 35 (24%) stage pT2, 25 (17%) stage pT3, and 11 (7%) stage pT4 disease. Frozen sections of tumor biopsies obtained by transurethral resection were immunohistochemically stained using the monoclonal antibody clone D0-7 (DAKO), which recognized two different epitopes for mutant and wild-type p53 protein. Tumors expressing p53 in more than 10% of the tumor nuclei were regarded as positive. The DNA ploidy was determined by image analysis. Immunohistochemical detection of p53 expression was found in 84 (57%) of the 147 tumors examined. Positive p53 staining was seen in grade I tumors in 10 to 25%, in grade II tumors 25 to 75%, and in grade III up to 58% of the tumor nuclei. There was a positive correlation between p53 expression and pathological stage (28% in pTa, 73% in pT1-2, and 68% in pT3-4 tumors). There was no appreciable relationship between DNA Ploidy and p53. Although carcinomas with p53 expression had a slight tendency to be more prevalent among higher disease stages and poorly differentiated transitional cell carcinoma, immunohistochemical detection of p53 is not a valuable tool for predicting the outcome of patients with TCC or for identifying subgroups of patients that may be at a higher risk for tumor progression.
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PMID:Immunohistochemical detection of p53 protein in transitional cell carcinoma of the bladder in correlation to DNA ploidy and pathohistological stage and grade. 946 48

We present a case of asynchronous development of transitional cell carcinoma in urinary bladder and renal pelvis after prolonged cyclophosphamide therapy. A 57-year-old woman had received 290 g cyclophosphamide for 13 years because of therapy for non-Hodgkin lymphoma. She was suffered from dysuria and macrohematuria and visited our clinic. Cystoscopy, CT and MRI revealed invasive bladder tumor and total cystectomy was performed. Histological diagnosis was transitional cell carcinoma, G3 < G2, pT4. Six months after the cystectomy, a follow up urography and computerized tomography showed left renal pelvic tumor. The patient underwent total nephroureterectomy, and the histological diagnosis was transitional cell carcinoma, G3, pT3. We reviewed cyclophosphamide induced urothelial carcinomas from Japanese and world literatures.
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PMID:[Cyclophosphamide induced urinary bladder and renal pelvic tumor--a case report]. 973 90

Cyclophosphamide (CPM) has been considered to be a factor of bladder carcinogen. A 60-years old woman had been received a total dose of 370 g of CPM for the treatment of Wegener's granulomatosis since August, 1977. She was consulted to our department with chief complaint of macrohematuria in August, 1986. Hemorrhage cystitis was diagnosed and cystoscopy and urine cytology were performed as follow-up schedule in every year. In 1996, urine cytology showed class IV and cystoscopy revealed multiple nonpapillary tumors. Abdominal computerized tomography demonstrated a low density mass on the posterior wall of the bladder. A transurethral cold cup biopsy showed G3 transitional cell carcinoma (TCC). Radical cystectomy and tubeless cutaneous ureterostomy was performed on December 6, 1996 and histopathological diagnosis was TCC, G 3, pT3 bNXM0. She died of liver failure due to metastatic bladder cancer after seven months postoperatively.
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PMID:[Cyclophosphamide-induced bladder cancer in a patient with Wegener granuromatosis]. 1006 8

Clinical studies were performed on 35 patients with renal pelvic and/or ureteral cancer treated at Kitano Hospital between 1988 and 1997. They consisted of 17 renal pelvic cancers, 17 ureteral cancers and 1 renal pelvic and ureteral cancer. Twenty-nine patients were males and six were females, and their age ranged from 41 to 82 years old (average: 62.2). Histologically, 34 were transitional cell carcinoma and 1 was adenocarcinoma. Pathological stage of the tumor was pTa in 34.3%, pT1 in 14.3%, pT2 in 11.4%, pT3 in 37.1%, and pT4 in 2.9%, and grade of the tumor G1 in 11.8%, G2 in 58.8% and G3 in 29.4%. Eighteen patients (51%) had or developed bladder cancer, which preceded the diagnosis of cancer of upper urinary tract in 2 cases, coexisted in 4 cases and developed subsequently in 12 cases. The overall cause-specific survival rate was 91.3% at 1 year, 83.8% at 3 years and 79.4% at 5 years. Tumor stage, grade, lymph node metastasis and vascular invasion had impact on survival.
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PMID:[Clinical studies on renal pelvic and ureteral tumors]. 1076 93

Renal transplantation (RTx) recipients have a high incidence of cancer, including transitional cell carcinoma (TCC). Posttransplantation urologic malignancies still present a challenge for transplant surgeons. Using the Dialysis and Transplant Registry of Taichung Veterans General Hospital, a total of 55 cancers were diagnosed in 52 RTx recipients between May 1983 and September 2001. Of these, 24 RTx recipients developing TCC were identified and presented the distinctly high percentage (43.6%) of TCC that were malignancies after RTx in Taiwan. The mean time between transplantation and initial diagnosis was 46 months in our series. Painless hematuria with pyuria is the most common mode of presentation. Transitional cell carcinoma of RTx recipients had multiple foci. Moreover, synchronous TCC in bilateral upper urinary tracts were confirmed in 9 (41%) recipients. The pathologic status of disease is invasive at diagnosis (pTa: 2, pT1: 7, pT2: 4, pT3: 6, pT4: 2, graft metastasis: 1 and distant metastasis: 2). Disseminated metastasis occurred in 6 recipients, all of whom died of their disease within 16 months. Five recipients received adjuvant chemotherapy and retained stable renal function. We conclude that RTx recipients have a markedly increased incidence of TCC in Taiwan, and that prophylactic bilateral nephroureterectomy of native kidneys with bladder cuff excision can be performed simultaneously in RTx recipients with TCC.
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PMID:Transitional cell carcinoma in renal transplant recipients. 1278 44

P63 is essential for the differentiation of normal urothelium and is also expressed in transitional cell carcinoma (TCC) of the bladder. We investigated p63 immunoreactivity in upper urinary tract TCC (n=53) and in renal-cell carcinoma (RCC; n=188) using a tissue microarray technique. P63 expression was detected in 51/53 (96.2%) TCCs, showing decreased expression in high-stage (pT1 and pT2 100%; pT3 90.9%) and poorly differentiated (G1 and G2 100%; G3 92%) tumors. All RCCs were negative for p63. P63 proved to be a helpful tool, even in poorly differentiated and undifferentiated renal malignancies, to distinguish TCC from RCC.
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PMID:P63 immunoreactivity distinguishes upper urinary tract transitional-cell carcinoma and renal-cell carcinoma even in poorly differentiated tumors. 1287 91

Cancer-testis (CT) antigens are ideal vaccine targets since their expression is restricted in adult tissues to testicular germ cells and a subset of cancers. The frequency of expression in transitional cell carcinomas (TCCs) of NY-ESO-1, the most immunogenic CT antigen to date, and its closely related gene LAGE-1 was studied. NY-ESO-1 and LAGE-1 antigen expression were found to occur frequently in high-grade TCC tumors. On an MSKCC IRB-approved protocol, 68 patient specimens were collected prospectively at the time of transurethral resection or cystectomy, of which 43 were read pathologically as high-grade tumors (pCIS, pTaG3, pT1, pT2, pT3, and pT4), 8 as low-grade tumors (pTaG1, pTaG2), and 17 as disease-free samples. These 68 samples were analyzed by immunohistochemistry (IHC) and/or RT-PCR. There were also an additional 53 paraffin-embedded specimens studied retrospectively by IHC, of which 39 were high-grade tumors and 14 were low-grade tumors. Cumulatively, our data indicate that NY-ESO-1 and/or LAGE-1 are expressed in 39/82 (48%) high-grade TCC and 3/22 (14%) low-grade TCC samples when analyzed by RT-PCR and/or IHC. Immunological assessment of these patients' sera identified one patient, whose tumor homogeneously expressed NY-ESO-1, which had detectable antibodies against NY-ESO-1 and LAGE-1. Further analysis of this patient, who remains clinically without evidence of disease 24 months after cystectomy for high-grade pT4 disease, revealed T-cell immunity against NY-ESO-1. This patient's T-cell response was determined to be specific for a new NY-ESO-1 epitope, p94-102, in the context of HLA-B35.
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PMID:Frequency of NY-ESO-1 and LAGE-1 expression in bladder cancer and evidence of a new NY-ESO-1 T-cell epitope in a patient with bladder cancer. 1468 Mar 60

To evaluate prognostic value of morphometric studies of the stroma of transitional cell carcinomas of the renal pelvis and ureter, we studied retrospectively the data of primary examination and follow-up of 75 patients (49 males, 65% and 26 females, 35%; mean age 61.9 +/- 1.2 years) given radical surgical treatment for cancer of the renal pelvis and ureter. Five-year survival in the absence of tumor progression was 23%. Morphological examination diagnosed transitional cell carcinoma with invasion pT1, pT2, pT3 and pT4 in 3(4%), 15(20%), 47(63%) and 10(13%) cases and differentiation degree G1, G2, G3 in 31(41%), 15(20%) and 29(39%) cases, respectively. In addition to the standard morphological examination of the tumor, we made morphometry of stromal and tumor area, analysed composition and count of stromal effector cells (lymphocytes, eosinophilic and neutrophilic leukocytes, macrophages, mast and plasmic cells), the degree of stromal vascularization. Prognostic value of the above parameters was estimated according to significance of their correlation with postoperative survival of the patients. The survival correlated with the depth of cancer invasion (p = 0.005) and differentiation of tumor tissue (p = 0.006), high cell infiltration of tumor stroma is prognostically unfavourable (R2 = 0.03; F = 3.41; p = 0.069) as well as weak presentation of stromal component of the tumor (p = 0.056). The lowest survival was observed in patients with cancer of the renal pelvis and ureter with a great number of mast cells (p = 0.056), macrophages (p = 0.037) and neutrophils (p = 0.029) in the tumor stroma. According to the results of multiple regression analysis (R2 = 0.08; F = 5.42; p = 0.024), five-year postoperative survival most closely correlated with cancer invasion depth (p < 0.001), degree of tumor cells differentiation (p < 0.001) and number of macrophages infiltrating tumor stroma (p < 0.001). Significance of survival prognosis for patients with cancer of renal pelvis and ureter can be raised by estimation of mean number of free stromal cells and expression of stromal component.
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PMID:[Prognostic implication of morphometric stromal parameters of renal pelvis and ureteral transitional cell carcinomas]. 1519 6

Although recent series have demonstrated that radical cystectomy can be safely performed in elderly patients, few if any, have examined the long-term success of this procedure. We sought to determine the long-term benefit and survival outcomes after radical cystectomy in the elderly, high operative risk patient. We reviewed the records of all patients undergoing radical cystectomy between July 1994 and January 2000. Of these 382 patients, we identified 38 patients with transitional cell carcinoma who met our predetermined selection criteria of elderly, high peri-operative risk patients [age > or = 75 years and American Society of Anesthesiologists (ASA) classification > or = 3]. We analyzed patient characteristics, presenting symptoms, pathology, outcomes, and survival. Median age was 79 years (75-87 years). All but a single patient underwent surgery for symptomatic disease. No patient died in the early perioperative period. At a mean follow-up of 22 months (3-90 months), 11/38 (29%) patients are alive. Of the patients with < or = pT2B pathology, 9/27 (33%) are alive and are disease-free. There are 2/11 patients (18%) with > or = pT3 pathology still alive with 1 of those patients (pT4a) alive with disease 34 months after his radical cystectomy. Kaplan-Meier survival curves demonstrate that patients with organ confined disease (< or = pT2B) had a significantly longer mean overall survival than patients with nonorgan confined disease (> or = pT3): 31 months vs. 18 months, P = 0.046. Cause of death was known in 17 patients, with the majority (14/17) because of bladder cancer. However, there were no local recurrences, and palliative goals were achieved in all patients. Our results validate radical cystectomy as a safe and effective treatment choice in the elderly patient with significant co-morbidities. These patients, most of whom are symptomatic, can achieve palliation of their symptoms, local control, and long term survival, especially if their bladder cancer is organ confined. Reluctance to offer timely, aggressive local therapy may compromise ultimate survival, even amongst high operative risk, elderly patients.
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PMID:Benefit of radical cystectomy in the elderly patient with significant co-morbidities. 1527 11


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